Buffalo Physicians

Atlanta Physicians

This is the portal for entering information to explore participation in the Fairview Physicians ACO Partnership.
Are You A Solo Practice or Group Practice?*

Solo PracticeGroup; I would prefer to enter Physicians IndividuallyGroup; I would prefer to upload a spreadsheet with all information

Individual Physician Entry

Please fill out all fields and then click Submit.
If you have any questions, please send a note with phone number to info@mdparadigm.com, and someone will contact you as soon as possible.
Name*

First NameLast Name
Organization or Practice Name*
Enter The Location Where You See Most of Your Patients*

CityState

Zip Code
Phone Number*

Area CodePhone Number
E-mail*
Billing TIN*
This is the TIN (individual or group) used when billing Medicare (9 numbers)
Individual Practitioner NPI*
10 numbers
Did You Bill Medicare Using a Different TIN at Any Time Between June 2015 and June 2017?*

YesNo
Enter Legacy TIN Here

Bulk Physician Entry
If you have any questions, please send a note with phone number to info@mdparadigm.com, and someone will contact you as soon as possible.
Organization or Practice Name*
1. Please Use the Link to Download a Blank Physician Excel form
2. Fill Out All Fields (descriptions provided below), One Line per Physician in your Organization/Practice
3. Save the File to Your Computer with your Organization or Practice Name in the Title
4. Click on the Upload Button to Upload Your Completed File
5. Once the File is Uploaded, Click "Submit"
Blank Physician List
Data Fields:
- First Name (practitioner's first name)
- Last Name (practitioner's last name)
- Organization or Practice Name (business entity name)
- City, State, Zip (location you see most of your patients)
- Phone
- Email
- Billing TIN (the TIN used when the practitioner bills Medicare. NUMBERS ONLY)
- Individual Provider NPI (NUMBERS ONLY)
- Legacy TIN (provide ONLY if you billed to a different TIN between June 2015 and June 2017)
Use the Button Below to Select a Completed Physician's List for Upload*

Upload a File

Cancelof
Should be Empty:

Atlanta Physicians